Individual provider Active NPI

Maisie Mae Floyd, LPC, SAC

  • Professional Counselor
  • Juneau, WI
National Provider Identifier
1750874822
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
7877-125 Issued in WI
Practice address
199 County Road DF FL 3
Juneau, WI 53039-9512
Phone
(920) 386-4094
Fax
(920) 386-4564
NPI assigned
Jun 12, 2018
Last updated
Dec 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 17098-131 WI
Professional Counselor 101YP2500X 7877-125 WI Primary

Addresses

Primary practice location

199 County Road DF FL 3
Juneau, WI 53039-9512

Mailing address

N5014 Northview Rd
Eden, WI 53019-1536
Phone (920) 904-6247

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240103000191 WI Practitioner - Mental Health Counselor 8022468032 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of DodgeGroup PAC ID 2466475587, 10 clinicians

Practice addresses (Care Compare)

199 County Rd DF
Suite 3
Juneau, WI 53039-9512
Phone (920) 386-4094

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17098-131WIMDAddiction (Substance Use Disorder) Counselor
7877-125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
County of Dodge CurrentSince Jan 1, 2024 Accepting new patients
County of Dodge CurrentSince Jan 1, 2024 Accepting new patients

Locations

199 County Road DF
#3
Juneau, WI 53039
Phone (920) 386-4094

199 County Road DF
Fl 3
Juneau, WI 53039
Phone (920) 386-4094

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1750874822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N5014 NORTHVIEW RD",
            "city": "EDEN",
            "state": "WI",
            "postal_code": "530191536",
            "telephone_number": "920-904-6247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 COUNTY ROAD DF FL 3",
            "city": "JUNEAU",
            "state": "WI",
            "postal_code": "530399512",
            "telephone_number": "920-386-4094",
            "fax_number": "920-386-4564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLOYD",
        "first_name": "MAISIE",
        "middle_name": "MAE",
        "credential": "LPC, SAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-12",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "17098-131",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "7877-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Juneau, WI

Sources for this page

Verify at the official NPI Registry.